Seek Giacometti’s “The Palace at 4 a.m.” Go back two hours. See towers and curtain walls of matchsticks, marble, marbles, light, cloud at stasis. Walk in. The beggar queen is dreaming on her throne of words…You have arrived at the web home of Marly Youmans, maker of novels, poetry collections, and stories, as well as the occasional fantasy for younger readers.

Youmans (pronounced like 'yeoman' with an 's' added) is the best-kept secret among contemporary American writers. --John Wilson, editor, Books and Culture

Sunday, June 19, 2011

Happy Father's Day, Michael!

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Bassett neurologist Michael Miller says Vietnam's pediatric hospitals
should focus less on technology, and more on old-fashioned physical exams.
Here, Miller examines a boy during a week-long humanitarian mission in March 2011.

ON CALL FOR CARE IN VIETNAMBack to basics for Bassett neurologist in Southeast Asia

--Trang Ho, special correspondent
Source: Columbia Magazine March 2011
and the Columbia University College of Physicians and Surgeons website.

Confused, in pain, and unable to walk, a 14-year-old girl rides piggyback on her much smaller mother, who is carrying her to see Dr. Michael Miller.

For them, it is a godsend that the clinical professor of neurology from Columbia University’s College of Physicians and Surgeons and the Bassett Healthcare Network happens to be volunteering at Nhi Dong Hospital 1 in Ho Chi Minh City this week through the Project Vietnam Foundation, a non-profit that provides pediatric care to the country’s underserved populations.

Bassett neurologist Michael Miller says Vietnam's pediatric hospitals should focus less on technology, and more on old-fashioned physical exams. Here, Miller examines a boy during a week-long humanitarian mission in March 2011.

Doctors at Vietnam’s 1,200-bed national pediatric facility couldn’t diagnose the girl’s problem, even after doing an MRI scan and observing her for 10 days. But experienced eyes and ears managed to discover what had eluded technology.

After spending a half an hour with the girl – more time than any other doctor at Nhi Dong could spare – Miller diagnoses her with Brown-Sequard Syndrome. Unfortunately, the rare form of paralysis, caused by an injury to the spinal cord, can’t be cured. But Miller recommends physical therapy that could dramatically improve her quality of life.

After doing rounds with Nhi Dong’s doctors and teaching them about neurological treatments in the U.S., Miller recommends that the hospital adopt simple procedures like Apgar scores, an easy way to assess newborn health, and head circumference measurements. Such tasks merely require time – not expensive technology – yet could dramatically improve quality of care.

“They think technology is going to be the answer to their problems when really, getting a full history and doing a thorough physical exam is the most important thing,” Miller says.

Aside from providing goodwill, Miller wanted a chance to see, first-hand, diseases eradicated long ago in the Western world, such as polio, tetanus and botulism. Things he has only seen in textbooks. “This is like practicing neurology in Paris in the 1840s or London in the 1890s or New York in the 1930s,” he says. “There’s much to learn.”

Even though he had to pay for his own airfare and lodging to volunteer in Vietnam, Miller is willing to do it again. He is surprised at how much fun he’s having, even though he can’t understand the language.

“I simply find the people joyful and charming,” he says. “They’ve been very open and kind.” For those interested in donating to the Project Vietnam Foundation, even money for little things, like hand sanitizer in all the hospital rooms to prevent the spread of disease, can reap big benefits.

If you poked your head in the playroom right now and saw all those gamers and Black Adder watchers going full tilt, you might not be so sure!

Yes, I am proud of him. He came from a blue collar background and worked his way on his own through a trade degree, a B. S., an M. S., and an M. D. And he has chosen to be a salaried academic doc, which I also admire.

It is a thing he has in common with my father, who was a sharecropper's child in the Depression and became a Professor of Analytical Chemistry.

I love reading about good people. The more I read, the more I realized that revelations here were making me so happy. I hope Michael had a very nice Father's Day indeed!What a smashing fellow.Thank you for posting this up and sharing with us, Marly.

He did, I believe. Our children were pretty good about it! They arranged for a lunch from Danny's, our little gourmet shop, and then Rebecca and I (with some help from Nate and Campbell, a visitor) made a dinner that Rebecca picked out--moussaka with a Greek spinach-tomato-rice dish. Since we didn't start until Rebecca got home from work, we served up dinner at 11 p.m. But that just made it a little more Greek!

RE: "'They think technology is going to be the answer to their problems when really, getting a full history and doing a thorough physical exam is the most important thing,” Miller says.'" --This could be said of American health-care, too--allowed no more than 15-min visits with each patient by their Hospital-owned clinics, doctors spend much of that time looking at the computer screen rather than the person.

I did give birth to two of the male species, but I don't think they come that way! It takes an awfully long swath of life to make one... They'd be hideously expensive.

Mary,

Well, I know that's not how Mike sees his patients, since neurology is a hands-on kind of discipline... and a lot of his procedures take a great deal of time. In fact, I have never had what you describe happen at our clinic. But new federal government regulations and systems coming on line will demand a lot more computer input from doctors--a mistake, in my mind, but so is much coming from that direction to doctors.

In defense of the 15-minute return visit: there are plenty of patients who don't need more than a few minutes on a return visit. If you gave every patient a visit the length of an initial visit, you would be wasting time--better to have the patients who need it return again in a longer slot.

And, of course, one thing about going to Vietnam is that nobody is wasting your time trying to get unjustified disability or being a high-demand person with a headache or faking a disorder. It's all genuine; it's all need and meaningful and often desperate.

The above is my own observation from knowing a lot of doctors for more than twenty years. It's not a doctor's statement.

Again, this is my own opinion from being in the presence of a lot of doctors for many years.

One thing that I've noticed is that there's a lot of difference regionally, according to culture ways. For example, in one place we lived there seemed to be much more courtesy to the doctor (no late or dirty patients, for example) and there were always genuine problems. In another, there was a good bit of discourtesy and a lot of time-wasting. I won't identify the regions but put everything in past tense...

But when you go to a place of need, you eliminate all of that sort of time-wasting.

My observation as a hanger-on in the medical world is that in priviliged society, there's a lot of people who who want either to get rid of the working life they hate (i. e. get disability) or else are so needy and lonely that they want to talktalktalk. That's a ruthless way to put it, but after some years floating about a hospital milieu, I believe it to be true.

Going to a place like Vietnam, doctors find that everything that happens all day is meaningful. They are giving a gift with love and it is received with love and gratitude. Such days are inspiring and renewing.

Alas, I must once again remind large numbers of Chinese salesmen and other worldwide peddlers that if they fall into the Gulf of Spam, they will be eaten by roaming Balrogs. The rest of you, lovers of grace, poetry, and horses (nod to Yeats--you do not have to be fond of horses), feel free to leave fascinating missives and curious arguments.

The Ferrol Sams Award; Silver Award in Fiction, ForeWord BOTYAs

A Death at the White Camellia Orphanagetells of a young boy's travels through the black heart of Depression American & his search for light both metaphorical & real. Writing with a controlled lyrical passion, Marly Youmans has crafted the finest, & the truest period novel I've read in years.-Lucius Shepard, 1943-2014

photo: Paul Digby, 7/2014

KINDRED SPIRITS

interior vignette, Glimmerglass

Praise for A DEATH AT THE WHITE CAMELLIA ORPHANAGE

*A REVIEWER:"Its themes and the power of its language, the forceful flow of its storyline and its characters have earned the right to a broad national audience"John M. Formy-Duval for About.com.

*A BOOKSELLER:"I agree with one reviewer that said this is destined to be an American classic." Nancy Olson, Quail Ridge Books, NC

Val/Orson

BOOKS AND CULTURE BOOK OF THE YEAR '09 UK: P. S. Publishing

Ingledove

Farrar, Straus & Giroux, 2005

Catherwood

Farrar, Straus and Giroux, 1996

Little Jordan

Boston: David R. Godine, Publisher, 1995

My friend Marly Youmans is one of America's finest writers. Anyone who knows her work even slightly would have little trouble reaching that conclusion. From the very beginning of my awareness of her work, I realized that her voice was unique, her grasp of technique in poetry and fiction stunning, and her imagination boundless. She seems to combine two impossible-to-resolve things simultaneously: traditional forms and an edgy, almost avant-garde sensibility.-novelist/poet Philip Lee Williams

The Throne of Psyche

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Lyrics, narratives, monologue, longpoem, short story, novella, novel.In 2015: "Maze of Blood." My newest novels are "Glimmerglass" and "A Death at the White Camellia Orphanage" (Mercer, 2014, 2012.) My newest collection of poetry is "The Foliate Head" (UK: Stanza Press, 2012), though last year saw "The Throne of Psyche" (Mercer.) Brand new: a post-apocalyptic epic in blank verse about a group of seven children, "Thaliad" (Montreal, CA: Phoenicia Publishing.) I was also on the judging panel of the National Book Award in Young People's Literature for 2012. I'm a mother of three, spouse of one, a Southerner among the Yanks!